This proposal addresses the NORA designated priority area of Surveillance Research Methodology and is based on a collaboration between the Center for Research on Occupational and Environmental Toxicology (CROET) at Oregon Health Sciences University (OHSU), the Environmental, Occupational and Injury Epidemiology Section of the Oregon Health Division (OHD), and major insurers for Workers' Compensation (WC) in Oregon. This collaboration brings together experts in epidemiology, surveillance, WC, and insurance plans for industry to advance the knowledge of worker injury and illness surveillance. Specifically we will address the disparities in data available in the state-mandated WC system and those available in the databases held by private insurers and self- insured companies. We will also provide for insurers that collaborate in this project evidence of the utility of surveillance data in understanding how the employers they insure compare with other employers in the state and the nature of their occupational injuries and illnesses. A research plan has been developed which will assess the feasibility and potential utility of WC claims data from multiple insurers into a common database for monitoring all types of WC claims. This transformation of claims data from multiple insurers will provide a broad view across insurers, will indicate any need for taxonomy development and standardization to facilitate the merging of data, and will provide the mechanism to compare illness and injury claims in relation to key variables. Upon successful merging of data from multiple insurers, this project will determine differences in the disabling and "medical-only" claims among different insurers according to type of injury/illness, age and gender of claimants, type of industry, and occupation. Comparisons will be made in the profile of occupational injury and illness available in state WC databases and the profile available in data from insurers. This project will demonstrate the utility of complete insurer databases in monitoring clusters of illness and injury, trends and patterns of claims and identifying new intervention opportunities as they emerge. The information generated from this surveillance can then be used to communicate to insurers the benefit of the surveillance for their loss prevention and the ultimate goal of improving worker safety and health and decreasing WC claims costs.